PRP for Baker’s Cyst

Do you have pain or swelling behind your knee? Does it limit your activities? Wondering if it will go away or if it is a cause for more concern? You may have a Baker’s cyst. Learn what that is and how PRP can help. 

Understanding Baker’s Cyst

A Baker’s cyst, also known as a popliteal cyst, is one of the most common conditions in the knee. It is a fluid-filled sac that forms on the backside of your knee. Often, it causes a visible bulge and can be tender to the touch. Some patients complain of pain, tightness, and restriction in range of motion. 

A Baker’s cyst is a warning signal that you have a knee condition that warrants further evaluation. If left ignored, it can lead to damage to the knee joint, persistent pain, and limited mobility.

Your knee is surrounded by a membrane called the synovial membrane. This membrane produces fluid that lubricates the knee and helps to move it smoothly. Sometimes the knee produces too much synovial fluid, causing knee swelling. 

Knee swelling that is localized on the backside of the knee is called a Baker’s cyst. They are more common in men than women and tend to occur between 35 and 50 years of age, although they can happen at any age. Most people with a Baker’s cyst experience no symptoms, but sometimes it can cause pain and swelling.

The cause of Baker’s cysts is not fully understood, but it’s thought that they may be caused by:

• a build-up of fluid inside the knee joint (known as synovial effusion)
• damage to the lining of the knee joint (posterior capsule tear)
• a problem with the way the knee joint moves (known as joint instability)
• a meniscus tear
• knee osteoarthritis
• patellofemoral dysfunction 

Baker’s cysts are a secondary issue, meaning they are like a barometer for the knee’s overall health. If you have a Baker’s cyst, it could mean that something is wrong with your knee, and you should see a doctor, as there may be an underlying issue that warrants further evaluation. 

There are other causes of knee pain not related to the knee. For example, a blood clot, also known as a deep vein thrombosis, can also present as pain and swelling on the backside of the knee. This is a serious medical condition with life-threatening consequences.

The Centeno-Schultz Clinic Regenerative PRP Treatment

PRP therapy is an effective treatment for Baker’s cysts and many of the underlying issues that cause them. PRP stands for platelet-rich plasma. It is a procedure that involves drawing a patient’s blood from their arm and spinning it in a centrifuge, thereby isolating and concentrating the platelets. 

Platelets are rich in growth factors that can increase blood flow, decrease inflammation, and accelerate healing. Treatment of Baker’s cysts involves identifying the underlying cause and addressing it. The Baker’s cyst is often drained under ultrasound guidance. PRP can then be injected into the damaged area(s) in the knee to reduce swelling and pain as well as improve joint function.

How Does PRP Work?

PRP works by delivering growth factors and signals that can initiate a tissue-healing response. To be most effective, PRP must be placed directly into the damaged tissue. This should be done via injection under direct ultrasound or fluoroscopy (X-ray) guidance. 

What to Expect During the Procedure

Before having a PRP procedure, you need to come off any medication that can inhibit platelet function, such as aspirin and NSAIDs (non-steroidal anti-inflammatory drugs) such as Ibuprofen, Aleve, Celebrex, Meloxicam, etc. You will need a blood draw, so you need to stay well-hydrated before that. 

The first step of the procedure is having your blood drawn from a vein in your arm, just like any other blood draw. However, for good quality PRP, much more blood is taken than typical blood drawn from labs, because the PRP should be concentrated to higher levels for optimal success. 

Once your blood is processed, you will come back for reinjection of the PRP. Some more nervous patients may take medication for relaxation – by mouth or through an IV. During this procedure, your knee will be cleaned to prevent infection, and you likely will have some local anesthetic injected to aid comfort. 

However, you cannot mix much local anesthetic with PRP as this can have a negative effect on the efficacy. First, the doctor will aspirate the Baker’s cyst under ultrasound guidance. Next, all the areas that your doctor found to contribute to your knee issues should be directly injected under ultrasound guidance as well. 

The procedure may take 10-30 minutes. After the procedure, you will likely have some soreness and swelling. For the first one or two days there will be some discomfort and swelling, as the first step in healing is inflammation. Then that should quickly resolve and the knee pain and swelling should gradually improve over weeks to two or three months. 

The Benefits of PRP for Baker’s Cyst

Platelet-rich plasma provides numerous advantages for treating Baker’s cysts, including the following:

Accelerates Healing

PRP accelerates healing so that you can quickly get back to the activities you need or love to do. 

Minimally Invasive

PRP is given via injection, which is much less invasive and much less risky than any surgery for the knee. This also means quicker recovery times, as there is no damage done to the knee that needs to heal as well. 

Alleviates Pain and Inflammation

PRP helps reduce inflammation and pain over time, which is the main goal.

Offers Long-Term Relief

PRP can provide long-term relief because it is not simply masking pain, it is treating the root causes of the Baker’s cysts. 

Our PRP Treatments Are Backed by Research and Expertise

Commonly, doctors and orthopedic surgeons who do not offer PRP treatments claim there is no evidence to support its use since it is new. Nothing could be further from the truth. PRP has been performed since the 1990s. There are hundreds of peer-reviewed published studies on the efficacy of PRP for orthopedic issues. 

For the knee alone, there are more than 30 of the highest level studies, randomized controlled trials (RCTs) that show PRP works for knee problems, compared to one for knee replacement. The following are two of these studies: A Research Update on PRP to Treat Knee Arthritis – Regenexx, Should You Get PRP Knee Injection? (regenexx.com). 

We have more research on PRP working for knee issues than any orthopedic surgery, as this study shows: 2023 PRP RCT Infographic and Study Failure Analysis – Regenexx. 

Also, research shows that the most common orthopedic surgery, meniscectomy, not only doesn’t show that this surgery is effective, but we know it actually worsens and speeds up arthritis in the knee! Meniscus Surgery Alternative: Please Read This First (regenexx.com), Regenexx Non-surgical Alternative to Knee Meniscus Surgery or Meniscectomy at Centeno-Schultz Clinic (youtube.com)

What Sets Our PRP Treatment Apart from Other Regenerative Options?

In most clinics that offer PRP therapies, the method of developing PRP involves removing a patient’s blood and running it through a simple bedside centrifuge machine (spinning machine) to separate the plasma and concentrate the blood platelets, which are then immediately extracted and used as the injectate. 

Some of these devices are not great at getting rid of unfavorable cells from the resulting mixture. For instance, you usually want to eliminate most of the white and red blood cells from the PRP as they can increase inflammation unnecessarily and could lead to unfavorable effects, especially in joints. 

Also, simple bedside machines don’t adjust for differences in patients’ plasma volume and blood consistencies. Bedside machines only can produce one concentration of PRP, so if higher concentrations are needed, they cannot accommodate it.

Platelet Concentrations

Our PRP is precise and customizable because it is produced in a laboratory setting by an experienced technician who can separate and concentrate all the blood’s good components and remove the unfavorable ones. We also can concentrate PRP much more than bedside machines and vary the concentrations based on the problems and patient.

Invented at the Centeno-Schultz Clinic, Regenexx’s super concentrated PRP procedures are an advanced type of PRP therapy that uses lab-processed PRP mixtures that have been found to provide up to 10 – 40 times more platelet concentrations than the traditional “bloody” PRP. Our PRP has an amber color due to its low levels of red blood cells. (See Figure 2.)

Successful Procedures for Baker’s Cyst

Since Baker’s cysts are a symptom of other knee issues, it is most important to diagnose the underlying issues and treat those along with aspirating a Baker’s cyst. We track all of our patients in a registry and publish our data on our website, which is updated monthly: Patient Results – Regenexx.

Meet CSC’s Pioneers of Interventional Orthopedics

Meet the interventional orthopedic doctors who perform the PRP injection procedures in Broomfield, Colorado:

Christopher J. Centeno, MD

Christopher J. Centeno, M.D. is an international expert and specialist in Interventional Orthopedics and the clinical use of bone marrow concentrate in orthopedics. He is board-certified in physical medicine and rehabilitation with a subspecialty of pain medicine through The American Board of Physical Medicine and Rehabilitation. Dr. Centeno is one of the few physicians in the world with extensive experience in the culture expansion of and clinical use of adult bone marrow concentrate to treat orthopedic injuries. His clinic incorporates a variety of revolutionary pain management techniques to bring its broad patient base relief and results. Dr. Centeno treats patients from all over the US who…

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John Schultz, MD

John R. Schultz M.D. is a national expert and specialist in Interventional Orthopedics and the clinical use of bone marrow concentrate for orthopedic injuries. He is board certified in Anesthesiology and Pain Medicine and underwent fellowship training in both. Dr. Schultz has extensive experience with same day as well as culture expanded bone marrow concentrate and sees patients at the CSC Broomfield, Colorado Clinic, as well the Regenexx Clinic in Grand Cayman. Dr. Schultz emphasis is on the evaluation and treatment of thoracic and cervical disc, facet, nerve, and ligament injuries including the non-surgical treatment of Craniocervical instability (CCI). Dr. Schultz trained at George Washington School of…

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John Pitts, M.D.

Dr. Pitts is originally from Chicago, IL but is a medical graduate of Vanderbilt School of Medicine in Nashville, TN. After Vanderbilt, he completed a residency in Physical Medicine and Rehabilitation (PM&R) at Emory University in Atlanta, GA. The focus of PM&R is the restoration of function and quality of life. In residency, he gained much experience in musculoskeletal medicine, rehabilitation, spine, and sports medicine along with some regenerative medicine. He also gained significant experience in fluoroscopically guided spinal procedures and peripheral injections. However, Dr. Pitts wanted to broaden his skills and treatment options beyond the current typical standards of care.

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Jason Markle, D.O.

Post-residency, Dr. Markle was selected to the Interventional Orthopedic Fellowship program at the Centeno-Schultz Clinic. During his fellowship, he gained significant experience in the new field of Interventional Orthopedics and regenerative medicine, honing his skills in advanced injection techniques into the spine and joints treating patients with autologous, bone marrow concentrate and platelet solutions. Dr. Markle then accepted a full-time attending physician position at the Centeno-Schultz Clinic, where he both treats patients and trains Interventional Orthopedics fellows. Dr. Markle is an active member of the Interventional Orthopedic Foundation and serves as a course instructor, where he trains physicians from around the world.

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Brandon T. Money, D.O., M.S.

Dr. Money is an Indiana native who now proudly calls Colorado home. He attended medical school at Kansas City University and then returned to Indiana to complete a Physical Medicine and Rehabilitation residency program at Indiana University, where he was trained on non-surgical methods to improve health and function as well as rehabilitative care following trauma, stroke, spinal cord injury, brain injury, etc. Dr. Money has been following the ideology behind Centeno-Schultz Clinic and Regenexx since he was in medical school, as he believed there had to be a better way to care for patients than the status quo. The human body has incredible healing capabilities…

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